The Observer's health editor says women ought to have C-sections instead of vaginal delivery.

[dizietsma]

\link{http://society.guardian.co.uk/health/news/0,,1723873,00.html\link to article}

I'm appalled. I haven't read it all the way through yet, but you can bet your bottom dollar I'll be writing to the Observer to complain about this shocking and irresponsible opinion piece.

Piffle, I wouldn't really say I made the choice solely on those two stories. I really already made the decision for an elective because 1. I believe it's best guarantee of avoiding and emergency section 2. I already didn't trust the NHS to take all precautions I would like as a result of my first birth. 3. was concerned about possible (however unlikely) scar abruption.

But, the stories I refer to certainly confirmed in my mind that I didn't want to try a VBAC.

It's funny you know, before my first child was born I never never never ever would have thought I'd ever even think about a caesarean. No reason really. It just wouldn't have occurred to me.

I thought I heard that the reson babies have gotten so much bigger so fast is because we take better care oof them in pregnancy now. For starters, we are now advised not to drink and smoke.

Uwila, I hope you don't take this the wrong way ... its a genuine question ...

If you distrust the NHS so much, and believe they could screw up your birth, why guarantee putting yourself in their hands and exposing yourself to the risk of screwing up by having a cs (unless you went private, of course?)

If I wanted to avoid the NHS, I think I'd hire an independent midwife and stay away from hospital, infection, scalpels wielded by people I don't trust - and have my baby at home.

By having a cs you yield all control to them. You can't even move to protect yourself, they could do permanent injury by siting the spinal wrong, could cut your bladder by mistake, could cut your baby by mistake (2% chance), could deliver your baby too soon causing breathing difficulties, over 10% chance your epidural won't work properly therefore you could feel the op, could give you MRSA, could leave you with adhesions, you have 20% chance of getting a post-op infection ...

Surely, if you don't trust em, its better to avoid them altogether? After all, you're not ill - just healthy (hopefully) and pregnant. There is a good argument that staying out of hospital is the best way to keep you and your baby healthy. No nasty germs your body aint used to, less stress, less chance of intervention ...

I wonder why some people with bad birth experiences on the NHS/mistrust of them respond by keeping out of hospital, while others jump into their operating theatres?

Interesting question rachp. I tend to sympathise with uwila. I had an em cs last time and it was the 'emergency' aspect that was no fun. I don't think I am distrusful of the NHS myself so much as distrustful of my body. I'm due in 6 weeks and have hired a doula and bought a birthing ball..,.but there's still a bit of me that wonders if I'd be better off emotionally as well as physically is I tied to get an elective cs (which my hospital won't be keen on).

Rochwen, I think you'll be hard pushed to schedule a cs for 33 or 35 weeks, as the risks to the baby of being born then are high. Yes, they can inject steroids as I'm sure you know to mature the lungs -- but unless its life or death, they like I think to wait as long as poss before doing a cs. Otherwise, there is much increased risk of transient tachnypoeia (sp?!) of the newborn.

I really would discuss this with your doc. How about, if you are dead set, arranging that as soon as you go into labour, you have a cs. Its not an emergency (hopefully) so nice and calm, no hurry, but then at least your hopefully perfectly healthy child chooses its birthday when he or she is fully mature and ready to be born. That way, your baby should need to spend less time in hospital after, and you can all be home together sooner.

How would you feel, and sorry if this is probing v sensitive areas, if your baby was perfectly positioned, no early labour, but was taken out too early and that lead to problems - because of what happened last time (which must have been really worrying), even though circumstances are completely fine this time?

My number 2 baby was all over the place: transverse, breech, head down, transverse, at one point all of the above in 1 hour. That was at 39 weeks. I was in hospital for a week as they were so worried I'd go into labour with him in a position that made cord prolapse much more likely. But, I didn't. And he settled down. He was head down and perfectly positioned when he came out at 41+1. Unfortunately (for me and him, in my view) it was by cs anyway, but not for that reason.

I am surprised such crap has come from the Observer, a paper I have a lot of respect for.

All the scientific evidence I have ever read says that C-sections are not good for baby or mother.

I do not object to C-sections in an emergency, obviously.

I was so petrified they would cut me up and zip out baby for any old excuse, I moved home from South to North London days before my DS was born so that I could give birth in a birth centre.

My sister went into emergency C-section for her first son in 1993, and to this day she has no idea WHY they did it as it was never properly explained to her.

tonton, there's a really good group who'll give you loads of support to get that faith in your body back - ukvbachbac on Yahoo! groups.

I know I had no faith whatsoever in my body when going for number 2, and ended up with a cs again. I can remember thinking 'maybe I'm just not designed to have babies' 'maybe I'm one of those people who never go into labour'. It took a lot of talking, and support, and reading about people who had done it before I knew I could do it, that birth was natural and fine, and I did give birth to number 3 after 2 cs. It was so worth it, and one of the best days of my life.

Wishing you all the very best. You can do this! You're doing everything right, getting a doula, thinking it all through now. I really would recommend that ukvbachbac group.

Crikey I just looked on the Guardian blog - who is that nutter shellshock? Scary mad person!

I'm a bit confused about it all to be honest. She's trying to say EC's should be a choice for everyone yet at the same time the RCM are debating whether to charge women for epidurals. Where is is heading, should we just go squat in a field?

Babies are getting bigger and females have always payed a price in agony and complications when giving birth for the fact that humans walk upright and not on all fours.

I know DP would prefer me to have a elective section next time as he was so traumatised by the first he thought me and the baby were going to die. I've toyed with the idea but think in my heart of hearts that I'd rather go vaginal if poss. I'm hoping it will be a bit easier.

My biggest worry would be meconium. I'd never even heard of this until after DS was born and I'll be scared to have another long delivery because of it.

In fact I think she has her argumnet about politics totally upside down.

I am absolutely positive that one of the reasons the C-section rate in Western Europe and USA is so high (between 20 - 30 % when in fact it should be at around the 10% global rate) is because doctors get their knickers in a twist about being sued. Any sign of "distress" and they zip babies out.

As a lawyer I can totally understand the NHS paranoia with being sued (defending a case in court costs them a heck of a lot more money than C-sections). But it does not justify tampering with natural births.

I am amazed she does not talk about "the politics of how to avoid being sued".

all fours might just be the best way to go, monkeytrousers, though the field might be a bit messy . Forcing women to lie on their backs, and pushing when they don't want to, doesn't seem to me to be half as natural as letting gravity help move babies down. In my only natural birth, and first labour, I pushed out a baby over 10 pounds with no problems on gas & air, standing up and leaning against the bed. It was great and remarkably painless. When they asked me to lie down to examine me though, I swore like a trooper and was in agony! As I was a VBA2C they wanted continual monitoring, so the poor midwife had to follow me round holding on the sensors, as there was no way on earth I could lie down to do labour.
Stay upright, do what feels right, move, squat, whatever: it worked for me and hopefully will for you too. Hope next time is a breeze compared to last time with a lot less agony and complications. Second ones often are, apparently.

corrr I'm vocal today, work avoidance

On meconium, it can be a sign of foetal distress but not necessarily. Especially if a baby is overdue, or breech, it can be quite normal. They usually like to check the baby's heart rate to rule out problems if there is heavy, thick mec. I only know this because when my waters broke with number 3 they were thick and brown. But, she was fine - just 15 days over, and ready for her first poo. As far as I know, they don't panic about mec in most cases. Might be worth a google.

I was on my back pusing out a 10.4 with the help of a ventouse and I was screaming to high heaven Rach! I think it was that that DP found so disturbing, bless him. Going to see what happens next time and hope I don't over contract again.

Rachp,
No offense taken on that question. I think it's a valid one. I think that most of the failings that occur in delivery rooms are not because the staff are bad, but because the hospital is understaffed and so those who are there are overworked. Too much is expected of them. So, if I have an elective section, rather than being neglected because midwives and nurses are busy tendin to other patients, I have the undivided attention of an entire team of doctors. Let me see if I can recall... 2 surgeons, 2 anaesthetists, one assistant whose title I don't know, one doctor waiting to inspect the placents for a study she is doing (have to yuck to this. I told her she was welcomed to it so long as she didn't show it to me.), oh yes, one husband. Must not forget him.

So, what you say about someone wanting a homebirth because they don't trust knife happy medical approach is probably the same idea. But obviously a different approach.

Sorry but this bullshit about bigger babies being relevant.
Are we too assume that a woman giving birth to a 5lb baby experiences a smoother, less painful delivery than a woman who delivers a 10lb baby?
If we took a poll of babies who were born by emergency c sections for problems such as no progress in birth canal etc
I bet they are not all whoppers.
My mother had me at 5lb 6oz (she smoked) and I was induced, episiotomy and forceps.
My brothers was 6lbs and forceps (no induction)
Cue 7 yrs later when she had my youngest brother, he was 10lb 2oz
No drugs, no tearing, the easiest of 3 births by far. Why. Because the first 2 births were in the UK where the hospital took charge of a mothers birth
My mum had my youngest db in NZ, where midwife led community care was core. She trusted someone and that someone saw her throughout pregnancy and delivery.
Coincidence?

Also about birth on all fours, OR leaning over a bed arms and head and shoulders on bed feet on floor, this allows you to sink to your kness and to use the floor as momentum for your pushing, something to focus yourself against.
I gave birth to my two this way and could not give birth any other way :)

Uwila, I also had a midwife, another nurse, a peadiatrican, but no placenta woman, lol. I felt really safe, there was a doctor in the room for every eventuality.

...and I agree, with a scheduled c/s you know what's going to happen - a scheduled c/s. If you going in for a vaginal delivery you don't know the outcome, you could have a really quick straight-forward delivery, or a days long labour that ends in ventouse or forceps and episiotomy or an emergency section (or heaven forbid both of the latter eeeek). Noone can anticipate whether or what kind of problems you might have, so they might not be prepared for it whereas at a scheduled c/s they are prepared for all eventualities.

(I know totally lame argument but one that is enough to convinces me.)

If we're comparing antenatal groups, the only person I ever saw again out of my antenatal group had a CS, but the epidural didn't work properly - I was having breakfast with her in the hospital when the anaesthetist came to talk to her - basically it had numbed the whole of one side of her body, toes to face, but left the other side with full feeling with the result that she felt the CS throughout.

Rochwen I beg to differ Who me?
The two times I turned up at delivery suite I knew exactly what was going to happen. In about 10 minutes time a baby would come out, very nicely thank you very much.
Mind over matter

Tortoiseshell, I'm always shocked when I here these one-sided epidural stories. This happened to me when I was induced for first baby. So I told the midwife, and she got the anaesthetist back in and she basically pulled the tube back a bit and it centered itself, and voila no feeling on either side. I can understand that it's difficult to feed the tube straight in, but I can't understand that it isn't fixed for the patient's comfort.

Rochwen, I have to disagree, purely based on my own experience. I thought twice I was going to have an easy elective cs, baby out in 10 mins, no probs.

What I got was:

• major blood loss when they cut through a big blood vessel by mistake
• nine attempts at a spinal, each one agony
• a drip exploding in one hand
• shaking and vomiting
• a consultant who whinged throughout about how much her arms hurt, whose bleeper went off every 2 mins
• severe BP drop after the op
• a baby that took 20 mins to extract by forceps once they were in
• a jaundiced baby
• a totally messed up internal and external scar, only rectified in second surgery
• a consultant who greeted my baby with the words "its a boy! Nah, only joking" even though the reason for the cs was that she had been diagnosed with a potentially serious condition when I was pregnant, and we were never sure if she would live
• 3 years of PND
• pain and loss of sensation for 3 years

and my caesareans were pretty unremarkable, non emergency, and without any of the MAJOR sequelae that can occur.

Some women end up with PTSD, another had a scalpel slash all the way down her baby's back, another felt the whole thing and had to go under GA, one had severe bladder damage, some women end up having a hysterectomy. I'm not scaremongering,
these are all what happened to real people, absolutely true stories of non emergency cs.

You don't always know what you're going to get. Either way.

Oh Rachp, I'm so sorry to hear about your experience. I hope you are ok now.

Cheers Rochwen, it feels like a long time ago now, and am absolutely fine! TBH, having a normal birth banished a lot of the demons and means I can look back on it all and be happy. Happy my kids are fine, and I'm through it all. And odd though it sounds, if it hadn't been so bad I would not be who I am now and would never have fought so hard for and possibly never got such a great birth 3rd time around. Don't regret any of it, funnily enough.

That's horrible, rachp.